Post-operative Instructions
John L. Washington, MD FACOG

Serious or worsening pain, heavy bleeding or a temperature over 102 is not normal. Call me or go to the Emergency Room. Use common sense. If you have any doubts, CALL ME.

All Surgery: Avoid constipation and straining. Take a laxative if needed. Drink plenty of fluids and eat a good diet, with enough fiber and vegetables. Get enough sleep and rest to allow your body to heal.

Laparoscopy: After simple laparoscopy, such as a tubal or removal of an ovary or lysis of adhesions, most people can go back to normal activities after 3 to 5 days. It takes a day or two to get over the anesthesia, the nausea goes away in 12 to 18 hours. After 24 hours it is ok to take a bath or a shower without worrying about the incisions. Keep bandaids on them if needed. Avoid very strenuous activities for about two weeks. A post-op visit should be scheduled for two weeks. If there has been no vaginal part to the  operation, you can resume sex in a few days.

Laparoscopic hysterectomy, LSH: The cervix is left in place and so there is not a weakening caused by a vaginal incision. Take it easy at home for one week. The second week, you can begin driving but avoid strenuous activity. Limit yourself to small tasks and get enough rest. How you feel is the best indication of your activity limitations if you don’t push yourself too much. Most people can return to a sedentary job in two weeks and to any activity in 4 weeks though really heavy lifting type of work should be avoided for 6 weeks. There should be no sex for around 4 to 6 weeks. Some spotting and discharge is normal.  We can discuss this and details about your work at your two week appointment. Do not use tampons. Bathing or showering is ok after 24 hours.

Laparoscopic Hysterectomy LAVH, cervix is removed: Same as LSH but there is weakening of the vagina and no lifting of more than 25 pounds for six weeks and no sex for six weeks. Do not use tampons. Bathing and showering is ok after 24 hours.

Sling operations and pelvic repairs, Cystocele and Rectocele: about the same as the Laparoscopic hysterectomy (LAVH) instructions but no lifting of over 25 pounds for six weeks. Lifting puts a strain on the pelvic floor and could cause weakening of the repair and pain. Bathing or showering is ok after 24 hour. Some discharge and spotting is normal. Nothing in the vagina and no sex for 4 weeks. Avoid serious straining, lifting 50 pounds for six months.

Abdominal Incisions, Laparotomy, Abdominal Hysterectomy: Keep the incision dry and covered for a week. Shower but no bath after 24 hours. Dry the incision carefully. Do not drive for two weeks and take it easy at home for this length of time. Have someone drive you to your appointment after one week to check the incision and remove staples if present. Do not lift over 25 pounds for 6 weeks. Plan to return to work in about 6 weeks. Do not have sex or put anything in the vagina for 6 weeks if you had a hysterectomy. Fatigue may be a problem. Get enough rest, take vitamins and iron and eat a good diet. If there is drainage from the incision, redness or infection, call me. Some vaginal drainage or spotting is normal.

Vaginal Hysterectomy: Same as Abdominal but there is no abdominal incision to take care of.

Hysteroscopy, Endometrial Ablation, D&C, Cystoscopy:  Same as Laparoscopy  except no intercourse  until any discharge goes away, usually 3 or 4 weeks.

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